When we visit doctors, we hope they can help us and care for us as people. As human beings, overall. But that just isn’t the case for a majority of Indian women. A 2019 study published in the British Medical Journal showed the obvious disparities that women face when trying to access the healthcare system. The study, conducted by All India Institute of Medical Sciences (AIIMS), Indian Statistical Institute, Harvard University, and the Prime Minister’s Economic Advisory Council, found that out of the 23,77,028 outpatients who visited the AIIMS facility from January 2016 to December 2016, only 37 per cent of the total were women and the rest were men.
Why women have lesser access to healthcare
Women were far less likely to get medical care because of the regressive attitude of their families and society, even though the 2016 National Sample Survey showed that more women than men fell ill that particular year. Along with this, it is important to note that women’s health isn’t considered as important as that of men in the country, despite all the progress we have made in empowering women in other aspects. There is a gap in the spending on healthcare and more often than not, money is spent on the welfare of the men and boys in families. Not only this, women often don’t have access to hospitals because of the distance between their homes and healthcare centres. According to the 2016 study by the National Family Health Survey, only 40 per cent of women are allowed to step out alone, even if it is to visit a health facility. Women are taught to prefer female doctors over males and when facing the latter, they shy away from discussing their health problems.
Let’s talk about more recent evidence of gender discrimination. Out of all the COVID vaccines that have been administered till January 2021, only 143 million have been given to women compared to 167 million given to men. This can be attributed to a number of issues including the popular stereotype that since men go out to work, they must be protected and cared for first.
The history of gender bias in healthcare
Gender bias means that there is a clear preference for one gender over others. Worldwide, the most common form of bias is against women. A 2020 study by the United Nations reported that 90 per cent of all people hold some of the other bias against women. Historically, women have always been considered inferior to men. They had been excluded from medical trials–regardless of their age, gender, sexual orientation, wish, or ability to bear children–from the ‘70s to the ‘90s mainly because they had been born with ‘child-bearing potential’ and limited eggs. Men were allowed to be a part of the trials because they constantly reproduce sperm, which meant that they were at a lesser risk for infertility. This policy has led to a medical system built by men for men and has introduced a bias against women where they’re viewed mainly as reproductive bodies. The studies that lack inclusivity, therefore, are flawed, which is one of the reasons why we have limited knowledge of women’s bodies today. This is also the reason why most women are over- or under-medicated today—how would we know the doses appropriate for women if there haven’t been enough trials that their their biology into account?
Delayed diagnosis
“After 15 years of battling extreme period pain–the kind that makes your stomach churn, your back ache along with heavy flow that went on for 10 days–I was diagnosed with endometriosis,” explains 34-year-old Rhea*. “I went to at least five different gynaecologists, three of them were men, in Mumbai during my teens. I was prescribed painkillers and sent away,” she explains. Most of them also told her that the chronic pain and fatigue she was dealing with was ‘normal’ and a ‘part of life.’ “I got an intrauterine device which has certainly helped with reducing the pain every month,” she explains. “If men suffered from a condition like that every 28 days, I think doctors would definitely pick up on symptoms earlier,” she adds.
“When I was 22, I was diagnosed with Crohn’s and this was after about six years of intensive testing and feeling extremely unwell. I have dealt with multiple flare-ups–think a stabbing pain or something like someone punching my insides–along with other symptoms like cramping, ulcers, and diarrhoea. Interestingly, on a support page, I made a male friend who told me he was diagnosed within seven months of his first stomach ache. We had one doctor in common that we both visited and this made me really think about how gender has a huge role in doctors taking your complaints seriously,” explains 28-year-old Nisha*. “They kept saying it’ll go away on its own despite there being a history of stomach issues in my family,” she adds.
Delayed or disparity in diagnosis isn’t just when women are dealing with a reproductive condition or digestive tract disease. A 2021 study presented at the European Society of Cardiology’s annual congress showed that heart attacks are misdiagnosed in women more frequently than men. The former are also provided clinical assistance much later than men.
The consequences of gender bias
Limited knowledge
Lack of inclusive studies means that doctors have less knowledge about women, intersex, and trans bodies. Illness manifest differently in different bodies and lack of all-encompassing research serves as a major drawback in treating them.
Gaslighting patients
When a patient is gaslighted, their diagnosis is delayed. Did you know, on average, a patient has to wait for more than six years to be diagnosed with a health condition like endometriosis? Not believing that their patients are in pain prevents doctors from helping them with relieving their symptoms.
Avoiding medical care
It takes a certain amount of patience and grit to constantly follow up with medical professionals year after year, even though you feel like you aren’t being taken seriously. People tend to lose faith in the medical systems and start avoiding them altogether.
The risk of dying increases
Heart attacks are thought to be male diseases which means that the symptoms that women experience aren’t studied as well. This leads to a higher rate of death amongst females.
5 signs your medical provider is gaslighting you
Gaslighting means making someone question their own sanity. When a doctor blames a patient’s symptoms on psychological factors or denies it altogether, that is called medical gaslighting.
• Diagnosing your condition based on your gender, identity, age, sexuality, or even something like your weight, without any further tests.
• Cutting you off when you’re trying to explain your symptoms.
• Blaming your symptoms on mental illness without asking you to consult a psychiatrist.
• Making you feel silly like you’re wasting their time and downplaying your symptoms.
• Making you doubt or question yourself.
What you can do as a patient
Advocate for yourself
You are your best cheerleader. Make sure you ask your doctor all the questions that are on your mind. There is nothing like a silly question, nothing at all.
Find a doctor who listens
If your medical care provider isn’t taking your concerns seriously, don’t give up. Look for a clinic that has a diverse team (think people of all ages, genders, and more). They may be able to help provide more comprehensive care.
Don’t give up on your health
If anything, the last two years have served as a wake-up call for all of us. Studies show that women have skipped preventative healthcare checks like breast cancer screenings during the pandemic because of an increase in responsibilities at home. Make sure you’re prioritising your own wellbeing.